Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined the value of serum albumin level as a predictor of medical complications and functional outcomes in 79 patients, age 65 years or older, who underwent comprehensive inpatient interdisciplinary rehabilitation for a first-time, unilateral, thromboembolic stroke. We recorded serum albumin levels at the time of admission to an inpatient rehabilitation unit, reports of the medical complications during rehabilitation, and Modified Barthel Index (MBI) Scores on admission and discharge. The mean (+/- SD) serum albumin level for all patients was 3.3 +/- 0.4g/dL. Forty-two patients (53%) had a total of 69 medical complications during rehabilitation. Mean serum albumin levels were 3.2 +/- 0.4g/dL for the group with complications and 3.5 +/- 0.3g/dL for the group without complications (t = -4.34, p < 0.001). Of the 37 patients with albumin levels > or = 3.5g/dL, only 32% had complications; of the 28 patients with levels from 3.0 to 3.4g/dL, 68% had complications; of the 14 patients with levels < or = 2.9g/dL, 79% experienced complications (chi 2 = 12.4, p = 0.002). There were positive correlations between serum albumin levels and the discharge MBI Self-Care Subscores, Mobility Subscores, and Total Scores (p < 0.001). There were also correlations between serum albumin levels and the Mobility and Total MBI Improvement Scores (p = 0.002 and p = 0.008, respectively). The relationship between serum albumin levels discharge destination approached statistical significance. Neither age nor side of lesion were related to serum albumin level, medical complication rate, or functional outcomes. Serum albumin levels appear to be related to medical complication rate and functional outcome in geriatric stroke patients. This suggests that older stroke patients with hypoalbuminemia may warrant closer medical attention or therapeutic intervention before and during rehabilitation.
 ...
PMID:Serum albumin level as a predictor of geriatric stroke rehabilitation outcome. 829 69

During a period of 3 years in a University Hospital in Israel, 339 episodes of bacteraemia were observed in patients 80 years of age or older, and 658 episodes in patients 60-79 years of age. Patients older than 80 were more often residents of nursing homes, frequently had a history of a cerebrovascular accident, but were less often neutropenic. Twenty-four per cent of bacteraemia episodes in the very old were hospital acquired compared with 40% in the old patients. The most common source of bacteraemia was the urinary tract, 50% of episodes in the very old, and 34% of episodes in the old. The percentage of episodes in which anaerobic bacteria were isolated was 5% in the very old and 1% in the old, and the difference was significant when corrected for the sources of bacteraemia. All cases of community-acquired bacterial endocarditis in patients of 80 or over were caused by pathogens originating from the gut. Thirty-five per cent of patients of 80 and over and 30% of patients aged 60-79 years died during hospitalization. Fatality was not associated with advanced age in the very old. Factors significantly and independently associated with fatality in both groups were a hospital-acquired infection, shock, low serum albumin, renal dysfunction and inappropriate antibiotic treatment.
 ...
PMID:Bloodstream infections in patients older than eighty years. 831 Aug 89

Patients with end-stage renal disease (ESRD) are known to have significantly reduced functional abilities, as measured by the Sickness Impact Profile (SIP). We investigated the clinical correlates with SIP scores in a cohort of patients with lesser degrees of renal dysfunction recruited from an academic general medicine practice (mean calculated creatinine clearance, 25 mL/min). Of 603 eligible patients with chronic renal insufficiency (CRI) defined as a serum creatinine greater than 1.5 mg/dL and a calculated creatinine clearance less than 50 mL/min on two occasions more than 6 months apart, 360 (60%) agreed to participate. These patients were primarily elderly (mean age, 69 years) black (83%), women (69.2%), with an average of 6 years of education and a household income of $400 to $800 per month; 92% had hypertension and 57% had diabetes. The SIP was administered in-home by trained interviewers. Independent variables included demographic data, education, income, and medications (via interviewers), vital signs taken by a renal nurse, and diagnostic test results and diagnoses from patient's computerized records. The total SIP score was the dependent variable, and its physical and psychosocial subscales were also investigated. Variables with univariate correlations with total SIP (P < 0.05) were included in a multiple regression analysis. All variables with a multivariable P value less than 0.10 were included in the final model. The mean SIP score was 24.5 +/- 15.6, higher than that found in patients on dialysis. Significant (P < 0.05) independent correlates with higher SIP scores (greater disability) were lower educational level and income, prior diagnoses of coronary artery disease and stroke, and lower serum albumin.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Clinical correlates of functional status in patients with chronic renal insufficiency. 843 Jun 76

Local cerebral blood flow, the permeability of the blood-brain barrier to sodium and serum albumin, and the content of electrolytes were investigated in rats before and at 4 h and 24 h following permanent occlusion of the middle cerebral artery (MCA). Measurements were carried out by triple tracer autoradiography, using 131I-iodoantipyrin, 22NaCl and 125I-iodinated bovine serum albumin, respectively. Regional sodium and albumin transfer coefficients were calculated by multiple time point analysis, and correlated with the corresponding flow and tissue electrolyte values. In sham operated controls regional sodium and albumin transfer coefficients ranged between 2.16-2.30 x 10(-3) and 0.22-0.48 x 10(-3) ml/min per g, respectively. Four hours after MCA occlusion sodium and albumin transfer coefficients were unchanged although tissue sodium content was already increased. After 24 h the sodium-but not albumin-transfer coefficient increased 2-3 fold but the rise in tissue sodium content was slower than after 4 h. At both ischaemia times the unidirectional sodium influx was substantially higher than the actual changes of tissue sodium content. The development of stroke oedema is, therefore, not limited by the alterations of barrier permeability.
 ...
PMID:Relationship between blood flow and blood-brain barrier permeability of sodium and albumin in focal ischaemia of rats: a triple tracer autoradiographic study. 843 21

To investigate whether back heating (BH) affects renal function, we applied an electric heating pad on the back skin overlying the kidneys in rats. In the acute experiment on saline-expanded, normal conscious rats, BH up to 42 +/- 1 degrees C for 15 min induced diuresis, natriuresis, kalliuresis, increased urinary kallikrein excretion as well as an increase in renal blood and plasma flow and glomerular filtration rate (GFR). When the rats were uninephrectomized and subjected to either BH twice a day for 1 week or a sham procedure, the study group showed a higher GFR per gram kidney weight and a higher increase in kidney/body weight ratio. When the rats were injected daily with cationic bovine serum albumin for 30 days and then subjected to either BH twice a day for 26 days or a sham procedure, the BH group showed a higher degree of proteinuria during the recovery period and a higher kidney/body weight ratio on the 27th day. Acute BH for 15 min in anesthetized rats increased body temperature, perirenal temperature, heart rate, stroke volume, cardiac output and cardiac index. Taken together, these results suggest that BH may affect the kidneys in normal and pathologic states. These effects may be at least partly related to a change in systemic hemodynamics.
 ...
PMID:Effects of heat therapy on renal hemodynamics, compensatory hypertrophy and glomerulonephritis in rats. 845 Sep 14

Tert-butyl hydroperoxide (t-BOOH)-dependent chemiluminescence of perfused rat lungs increased by almost 500% upon addition of heme (from 297 +/- 28% to 1204 +/- 125% of control, p < 0.01 vs no heme). Preincubation with hemopexin significantly decreased the heme-stimulated chemiluminescence to 779 +/- 155% of control (p < 0.01) When hemopexin was replaced with rat albumin heme-stimulated chemiluminescence decreased to 1007 +/- 104% (not significantly different from results with heme alone). In vitro studies showed that hemopexin did not decrease chemiluminescence from bovine serum albumin oxidation (493 +/- 94% compared to 292 +/- 81% of control in the absence of hemopexin) and that the heme-hemopexin mixture also emitted light when exposed to t-BOOH (264 +/- 66% of control). These results suggest that hemopexin specifically inhibits some of the oxidative reactions catalyzed by free heme and may have a protect tissue oxidation in conditions in which heme release occurs (i.e., stroke).
 ...
PMID:Protective role of hemopexin on heme-dependent lung oxidative stress. 847 38

The positron emission tomography (PET) and single photon emission CT (SPECT) revealed the pathophysiology of ischemic brain in the transaxial images. There are several limitations in PET studies by continuous inhalation method using oxygen-15 labeled gases. There has been a suspicion about the constancy between the red cell volume and plasma volume in the ischemic brain. We measured plasma volume by PET using Cu-62 labeled human serum albumin in cases of internal carotid artery occlusion. There was no remarkable plasma volume alterations between the ischemic and non-ischemic hemisphere. Powers et al demonstrated the relationships between the intracranial perfusion pressure changes and vascular or metabolic adaptations. The important issue in acute stage of stroke is to differentiate the truly alive and completely destroyed tissue. Cerebral blood flow change might be affected during acute stage by diaschisis. Recent examination using benzodiazepine receptor imaging by SPECT might have a potential to depict the damaged tissues, because cortical neuronal cell bodies have a lot of the receptors and an ischemic insult induces the loss of the receptors. The relationship of crossed cerebellar hypoperfusion (CCH) and supratentorial circulatory conditions is attractive, because supratentorial hypometabolism of oxygen induced more severe CCH in internal carotid artery occlusion. Therefore, we can predict the supratentorial oxygen metabolism by CCH in a case of internal artery occlusion. We have a lots of tools to explore the pathophysiological states of ischemic brain. These must be dedicated to develop the more effective therapeutic procedures.
 ...
PMID:[Positron emission tomography and single photon CT in the diagnosis of cerebrovascular disorders]. 875 69

The authors present a plan for pharmacological treatment of pressure sores in patients affected by neurological pathologies: cerebrovascular accidents, head injuries, spinal cord injuries. This plan is easily applicable to all pressure sores included between first and third degree of the Reuler and Cooney classification. Authors identified some drugs specifically usefull in different cutaneous lesion degrees. Skin lesions and employed medicines are described as follows: Erythema: semi occlusive bandage with porous adsorbing membrane. This dressing must be left in for five days at least. Excoriation: bactericidal or bacteriostatic medicines if it's situated in a non pressed area while the same dressing utilized for erythema if it's localized in a pressed area. Pressure sores: if there is local infection cleanse the wound from bacterial defilement using topic antibiotics apply compresses with vitamin C if the cutaneous lesion is larger than deeper, Cadexomero lodico if it's deeper than larger. Fistulas: wadding with tablets of collagen. Necrobiosis: complete or partial surgical removal of eschar preceded by the use of enzymatic drugs when eschar is firmly adherent to subcutaneous tissues. The first group collects 9 patients with stroke and head injury: 8 with sacral and 1 with heel pressure sores. First degree pressure sores heal within 45 days and third degree lesions within 160 days. The second group collects 10 spinal cord injury patients mostly with complete lesion among which: 7 sacral, 1 heel, 1 ischiatic and 1 malleolar lesions. First degree pressure sores heal within 30 days, third degree pressure sores heal within 200 days. Healing time are considered acceptable. Pressure sores recovery swiftness can be related to different factors such as pressure sores sterness, neurological pathology and arising of clinical complication (hyperthermia, infections, low serum albumin values, etc).
 ...
PMID:[The treatment of decubitus lesions]. 876 88

Stroke-prone spontaneously hypertensive rats (SHRSPs) have been widely used as models of hypertension and cerebral apoplexy. They were obtained by selective sib-breeding of Wistar Kyoto rats with higher blood pressure than rats of the original Wistar Kyoto strain. For vitrification of SHRSP 2-cell embryos, DPS solution containing 2.75 M dimethylsulfoxide, 2.75 M propylene glycol and 1.0 M sucrose was prepared and diluted in a modified phosphate-buffered saline, PB1, containing 0.3% bovine serum albumin. Embryos were exposed to the resulting solution in one step at room temperature, kept in the solution for 15 s, vitrified in liquid nitrogen, and warmed rapidly. The post-warming survival rate as morphologically assessed was 70% (148/210), which was comparable (P > 0.05) to the rate of 88% (78/89) for the solution control. After vitrification, the embryos were transferred into recipient animals, and 62% (48/78) were normally delivered, comparable (P > 0.05) to the percentage for the solution control (68%, 57/84). These was no significant difference between pups from vitrified embryos and those from unvitrified control embryos in either the growth curve or degree of blood pressure increase. These findings demonstrate the effectiveness of the simple vitrification method we used for cryopreservation of SHRSP and Wistar rat 2-cell embryos, and also demonstrate that vitrification-mediated cryopreservation does not affect the phenotypic characteristics of SHRSPs.
 ...
PMID:Successful vitrification of stroke-prone spontaneously hypertensive and normal Wistar rat 2-cell embryos. 878 74

The Steno hypothesis suggests that albuminuria reflects widespread vascular damage (proliferative retinopathy and severe macroangiopathy) due to a generalized vascular (endothelial) dysfunction. We assessed this concept in NIDDM (non-insulin-dependent diabetic) patients with (13 female/ 39 male, age 60 +/- 7 years, group 1) and without (12 female /41 male, age 61 +/- 7 years, group 2) diabetic nephropathy compared to matched non-diabetic subjects (7 female/15 male, age 58 +/- 8 years, group 3). A 12-lead ECG was recorded and coded blindly using the Minnesota Rating Scale; the World Health Organization cardiovascular questionnaire was used to assess past and present evidence of myocardial infarction, angina pectoris, stroke, and peripheral vascular disease (digital systolic blood pressure determination). The degree of diabetic retinopathy was scored from fundus photography. The following variables were measured: transcapillary escape rate of albumin (initial disappearance of intravenously injected 125I-labelled human serum albumin), plasma concentrations of prorenin (radioimmunoassay) and serum concentrations of von Willebrand factor (enzyme-linked immunoadsorbent assay). Prevalence of ischaemic heart disease (ECG reading) (49/20/5)% and peripheral vascular disease as indicated by reduced systolic blood pressure on big toe (69/30/ 14)% was significantly higher in group 1 vs group 2 (p < 0.01) and in group 2 vs group 3 (p < 0.01), respectively. The prevalence and severity of retinopathy was higher in group 1 vs 2 (p < 0.01). Transcapillary escape rate of albumin (%/h) was elevated in group 1 and 2 as compared to control subjects: 7.9 (4.3-13.7); 7.4 (3.7-16.4) vs 6.0 (3.4-8.7), (p < 0.005), respectively. Plasma prorenin activity (IU/ml) was raised in group 1 and group 2 as compared to group 3: 272 (59-2405); 192 (18-813), and 85 (28-246), p < 0.001, respectively. Serum von Willebrand factor (IU/ ml) was elevated in group 1 as compared to group 2 and 3: 2.07 (0.83-4.34); 1.60 (0.30-2.99) and 1.50 (1.00-2.38), p < 0.001, respectively. Our study demonstrated that NIDDM patients with and without albuminuria had increased transcapillary escape of albumin and raised prorenin activity, whereas only those with albuminuria had increased von Willebrand factor. Patients with NIDDM may have abnormal endothelial function in the absence of albuminuria.
 ...
PMID:Macro-microangiopathy and endothelial dysfunction in NIDDM patients with and without diabetic nephropathy. 896 Aug 47


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>